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Be the first to comment - What do you think?  Posted by admin - September 15, 2017 at 10:11 am

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Molina Healthcare Completes Acquisition of the Total Care Medicaid Plan in Upstate New York from Universal American | Business Wire

LONG BEACH, Calif. & WHITE PLAINS, N.Y.–(BUSINESS WIRE)–Molina Healthcare, Inc. (NYSE: MOH) and Universal American Corp. (NYSE:

UAM) jointly announced today that Molina has completed its acquisition

of Universal American’s Total Care Medicaid plan. As a result,

approximately 38,000 Total Care Medicaid members will now be a part of

Molina Healthcare.

“We are looking forward to welcoming and sharing our care model with our

newest members in New York,” said J. Mario Molina, MD, president and

chief executive officer of Molina Healthcare, Inc. “With the completion

of this acquisition, Molina now operates health plans in the five

largest Medicaid markets in the country and we are proud to continue

carrying out our mission of providing access to high-quality health care

to people receiving government assistance as we’ve done for more than 35


Total Care is a prepaid health services plan that provides health

insurance coverage in New York. Total Care covers approximately 38,000

members of the Medicaid Managed Care, Health and Recovery Plans (HARP)

and Child Health Plus (CHP) programs in four counties: Cortland,

Onondaga, Oswego and Tompkins. Under the terms of the agreement, Molina

has acquired all the outstanding equity interests of Today’s Options of

New York, Inc., which operates the Total Care Medicaid plan.

“Total Care has a long history serving the central New York community,

and we will continue to work closely with the New York State Department

of Health, local providers and community organizations to serve our

members, but now as part of the Molina Healthcare extended family,” said

Colleen Schmidt, president of Total Care. “We’re confident that this

will be a seamless transition given Molina’s focus on government health

care assistance programs. Molina shares a similar mission and values

with Total Care, and we are excited to tap into the knowledge,

experience and resources that Molina brings.”

Richard A. Barasch, chairman and chief executive officer of Universal

American, commented, “With the sale of our Total Care Medicaid plan, we

can better concentrate our efforts on our Medicare Advantage and

Medicare ACO businesses. We believe that Molina’s extensive experience

in Medicaid will allow for continued improvements to the plan for the

benefit of its members. We want to thank all the Total Care employees

for their dedication, professionalism and hard work.”

About Molina Healthcare

Healthcare, Inc., a FORTUNE 500 company, provides managed health care

services under the Medicaid and Medicare programs and through the state

insurance marketplaces. Through our locally operated health plans in 12

states across the nation and in the Commonwealth of Puerto Rico, Molina

currently serves approximately 4.3 million members. Dr. C. David Molina

founded our company in 1980 as a provider organization serving

low-income families in Southern California. Today, we continue his

mission of providing high quality and cost-effective health care to

those who need it most. For more information about Molina Healthcare,

please visit our website at

About Universal American Corp.

its family of healthcare companies, Universal American provides health

benefits to people covered by Medicare. The company is dedicated to

working collaboratively with healthcare professionals, especially

primary care physicians, in order to improve the health and well-being

of those they serve while reducing healthcare costs. More information

about Universal American is available at

Safe Harbor Statement under the Private Securities Litigation

Reform Act of 1995: This press release contains “forward-looking

statements” regarding the transaction between Universal American Corp.

and Molina Healthcare, Inc. All forward-looking statements are based on

current expectations that are subject to numerous risk factors that

could cause actual results to differ materially. Such risk factors

include, without limitation, risks related to: the ability of Today’s

Options of New York, Inc. (“TONY”) to maintain relationships with

customers and employees following the announcement of this transaction;

the integration of the operations and employees of TONY into Molina

Healthcare’s business; the retention and renewal of TONY’s business

contracts; synergies from the proposed transaction; and TONY’s future

financial condition and operating results. Additional information

regarding the risk factors to which the parties are subject is provided

in greater detail in their respective periodic reports and filings with

the Securities and Exchange Commission, including each party’s most

recent Annual Report on Form 10-K. These reports can be accessed under

the investor relations tab of each party’s website or on the SEC’s

website at

Given these risks and uncertainties, neither party can give assurances

that its forward-looking statements will prove to be accurate, or that

any other results or events projected or contemplated by its

forward-looking statements will in fact occur, and each party cautions

investors not to place undue reliance on these statements. All

forward-looking statements in this release represent the parties’

judgment as of the date hereof, and each party disclaims any obligation

to update any forward-looking statements to conform the statement to

actual results or changes in a party’s expectations that occur after the

date of this release.

Be the first to comment - What do you think?  Posted by admin - September 12, 2017 at 12:21 pm

Categories: Health   Tags: , , , , , ,

Is 50 Really the New 30? Your Immune System May Not Think So | Business Wire

CHICAGO–(BUSINESS WIRE)–The American Lung Association in partnership with Pfizer announces the

launch of WHO PNEU?™, a public awareness campaign encouraging

Baby Boomers and older Gen X-ers to recognize their personal risk for

pneumococcal pneumonia — a serious lung disease1 that can be

spread by coughing and sneezing.2 An estimated quarter of a

million US adults over 50 are hospitalized each year with pneumococcal


On behalf of Pfizer and the American Lung Association, Harris Poll

conducted a telephone survey of 1000 U.S. adults aged 50 to 75. Findings

from this survey showed that 85 percent of respondents think people 50

and older are at risk for pneumococcal pneumonia, but only 1 in 2 (50

percent) agree they are personally at risk.5

“While many of us over 50 may act and feel younger, the truth is our

immune system naturally weakens with age, putting us at increased risk

for infectious diseases. With WHO PNEU?, we are providing a

wake-up call for these adults to talk to their doctors and see if they

are up to date on their vaccinations,” said Harold P. Wimmer, National

President and Chief Executive Officer of the American Lung Association.

Starting this fall, WHO PNEU? will roll out a national PSA

(public service announcement) campaign on television, radio and print,

featuring actor, director, producer and philanthropist Tim Daly.

“Some people think you have to be elderly and in the hospital to get

pneumococcal pneumonia, but that’s not so,” said Freda Lewis-Hall, MD,

Chief Medical Officer of Pfizer. “Anyone can get pneumococcal pneumonia

anywhere and at any time, and the risk increases after we turn 50.6

It’s also important to understand that pneumococcal pneumonia can be a

really serious condition and shouldn’t be taken lightly.”

Daly, 59, who currently stars as Henry McCord in the CBS hit series Madam

Secretary, and is well known for his lead TV roles in The Sopranos,

Private Practice and Wings, knows firsthand about the risk

of pneumococcal pneumonia. His mom was hospitalized with the disease for

over a week in 1991.

“At first, my mom thought she had a bad cold, but the second I saw her I

knew something was seriously wrong. She looked horrible. She was very

weak and pale, and struggling to breathe,” said Daly, recounting the day

he visited his mom and then decided to drive her straight to the

hospital emergency room. “The experience with my mom really scared me

because she got really sick.”

Now in his 50s, Tim is more cognizant of his health. By joining forces

with WHO PNEU? he hopes to drive greater awareness of personal

risk for pneumococcal pneumonia among his peers, beginning with a

preview of the campaign survey results that offer a glimpse into what

adults 50 to 75 are thinking about the disease, such as:

  • Only about half of adults 50 to 75 (53%) surveyed understand that

    pneumococcal pneumonia does not only affect the very young and

    elderly. In fact, anyone can get pneumococcal pneumonia anywhere and

    at any time, and the risk increases as they get older.5

  • Survey results showed that a majority of respondents know the

    following is true about pneumococcal pneumonia:

    • 85 percent and 91 percent of respondents recognize that

      vaccination and hand washing, respectively, can help reduce the

      risk of getting pneumococcal pneumonia.5

  • The survey results also suggest a misperception among respondents when

    it comes to ways to reduce the risk of getting pneumococcal pneumonia.

    • For instance, 36 percent think wearing layers can help to reduce

      the risk of pneumococcal pneumonia.5

    • And, a quarter (25 percent) think holding their breath when

      someone coughs or sneezes around them can help reduce risk.5

Adults over 50 can visit to take a personal risk

assessment for pneumococcal pneumonia, learn more about the disease,

view the video PSA and hear more of Tim’s personal story.


About Pneumococcal Pneumonia

The most common form of bacterial pneumonia, pneumococcal pneumonia is a

serious lung1 disease caused by the Streptococcus

pneumoniae bacteria and is often spread through coughing or

sneezing, and close contact with an infected person.2 Common

symptoms may include difficulty breathing, excessive sweating, and high

fever with shaking and chills, a productive (mucus) cough that persists

or gets worse, and chest pain.1

About the WHO PNEU? Campaign and Survey

The American Lung Association in partnership with Pfizer developed the WHO

PNEU? campaign to educate adults 50 and older about their risk for

pneumococcal pneumonia, a serious lung disease.2 The

campaign’s mission is to raise awareness about personal risk for

pneumococcal pneumonia and encourage adults 50 and older to check with

their doctors to see if they are up to date on their vaccinations.

A national survey was conducted via telephone in the US by Harris Poll

on behalf of the American Lung Association and Pfizer between June 22

and July 8, 2015. The research was conducted among 1000 adults aged 50

to 75. Results were weighted where necessary to bring them into line

with the actual proportion of the population.

About the American Lung Association

The American Lung Association is the leading organization working to

save lives by improving lung health and preventing lung disease, through

research, education and advocacy. The work of the American Lung

Association is focused on four strategic imperatives: to defeat lung

cancer; to improve the air we breathe; to reduce the burden of lung

disease on individuals and their families; and to eliminate tobacco use

and tobacco-related diseases. For more information about the American

Lung Association, a holder of the Better Business Bureau Wise Giving

Guide Seal, or to support the work it does, call 1-800-LUNGUSA

(1-800-586-4872) or visit:

Pfizer Inc: Working together for a healthier world™

At Pfizer, we apply science and our global resources to bring therapies

to people that extend and significantly improve their lives. We strive

to set the standard for quality, safety and value in the discovery,

development and manufacture of health care products. Our global

portfolio includes medicines and vaccines as well as many of the world’s

best-known consumer health care products. Every day, Pfizer colleagues

work across developed and emerging markets to advance wellness,

prevention, treatments and cures that challenge the most feared diseases

of our time. Consistent with our responsibility as one of the world’s

premier innovative biopharmaceutical companies, we collaborate with

health care providers, governments and local communities to support and

expand access to reliable, affordable health care around the world. For

more than 150 years, Pfizer has worked to make a difference for all who

rely on us. To learn more, please visit:


1 Centers for Disease Control and Prevention. Pneumococcal

Disease. Symptoms & Complications.

Accessed December 4, 2013.
2 Centers for Disease Control

and Prevention. Risk factors & transmission.

Updated June 6, 2013. Accessed May 11, 2015.

Healthcare Cost and Utilization Project (HCUP). April 2015. Agency for

Healthcare Research and Quality, Rockville, MD.

Centers for Disease Control and Prevention. Epidemiology and Prevention

of Vaccine-Preventable Diseases. The Pink Book: Course Textbook. 13th

edition. Washington, DC. 2015.
5 Harris Poll.

Pneumococcal Pneumonia Survey, conducted via telephone by Harris Poll

among US 50-75 year olds on behalf of the American Lung Association in

partnership with Pfizer from June 22 to July 8, 2015.

Weinberger B, Herndler-Brandstetter D, Schwanninger A, Weiskopf D,

Grubeck-Loebenstein B. Biology of immune responses to vaccines in

elderly persons. Clin Infect Dis. 2008; 46(7):1078-1084.


Be the first to comment - What do you think?  Posted by admin - September 11, 2017 at 6:22 pm

Categories: Health   Tags: , , , , , , , , , , ,

Medicare Remedy Coverage For Lymphedema

Finding Medicare to understand lymphedema remedy as essential health care expenditure has been a tough job. Lymphedema individuals have been extensive striving to get the reward of Medicare for the charges that they incur for the remedy that carries on all through their life. The Women’s Overall health and Most cancers Legal rights Act states that problems arising owing to breast cancer surgical procedures, which includes lymphedema, have to be covered by all insurance companies. Nonetheless, this coverage does not prolong to these who undergo from major or secondary lymphedema. In February 2008, the compression garments thought of an essential portion of lymphedema remedy ended up classified as covered things for Medicare.

Lymphedema is a ailment that has no health care heal, although it can be managed with remedy which is recognized as the Entire Decongestive Remedy or CDT. The system requires a lymphatic massage put together with the use of compression bandages and compression garments, a skin care schedule and a standard exercise program. The most vital factor of the remedy is the manual lymph drainage (MLD) which aims at draining the stagnated lymph to minimize the swelling. Once in a while, the therapist may possibly use the Sequential Gradient Pump to loosen fibrotic tissues in advance of the massage. The therapist carrying out the lymphatic massage is a specialised skilled experienced in the system. Remedy sessions in the early levels may possibly be held routinely, at least 5 times a week. Those people who do not have quick entry to the…


Be the first to comment - What do you think?  Posted by admin - September 2, 2017 at 2:04 am

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Take Care Health Systems Expands Treatment for Skin Conditions and Minor Injuries | Business Wire

CONSHOHOCKEN, Pa.–(BUSINESS WIRE)–Take Care Health Systems, a wholly-owned subsidiary of Walgreens

(NYSE:WAG) (NASDAQ:WAG) and the largest and most comprehensive provider

of convenient care clinics and worksite health and wellness centers in

the country, is now offering a new set of procedures for skin conditions

and minor injury treatments.

As part of this expansion of services, Take Care Clinics now offer the

following procedures:

  • Wart removal with Cryotherapy

  • Skin tag removal

  • Closure of minor cuts with Dermabond®

  • Treatment of skin irritations (Contact Dermatitis)

  • Expanded scope of skin evaluation and treatment for skin infections,

    injuries and rashes

Take Care Clinics provide access to high-quality, convenient and

affordable health care to meet the needs of patients and their families.

The addition of these new services is a result of feedback from

patients, Take Care Health Providers and recent research which

identified a desire for the treatment of these types of skin conditions

in the convenient care setting. According to the Department of Health

and Human Services, over 48 million skin examinations are conducted each

year, which result in 3.2 million viral wart procedures and 3.3 million

skin tag removals.

“Patients are very satisfied with the service and offerings at Take Care

Clinics, and we’ve found that they are looking for additional

high-quality, convenient and affordable treatment options in our care

setting,” said Peter Miller, Take Care Health Systems’ president and

CEO. “We will continue to evaluate and implement new services which meet

the needs of patients and can be offered with clinical excellence at

Take Care Clinics.”

Take Care Clinics are professional walk-in health care centers open

seven days a week, with extended evening and weekend hours. Clinics are

staffed by board certified nurse practitioners and physician assistants

who treat patients 18 months and older for common illnesses such as

strep throat, ear and sinus infections, pink eye and poison ivy, and are

able to write prescriptions when necessary. The clinics also offer

preventative services, such as camp, sport and back-to-school physicals;

men’s and women’s health evaluations and vaccinations including GARDASIL

(HPV), Menactra (Meningitis), the Shingles vaccine and others.

Take Care Health Systems encourages all patients to have a health care

home, a primary care provider they see for ongoing medical needs and

routine exams. If a patient’s condition falls outside the scope of

service at a Take Care Clinic, the patient is referred to an appropriate

site for care, such as a primary care provider or specialist.

“Take Care Health Systems employs exceptional health care professionals

who are educated and prepared to offer high-quality treatment for an

array of skin conditions,” said Sandra Ryan, RN, MSN, CPNP, FAANP and

chief nurse practitioner for Take Care Health Systems. “If a patient at

a Take Care Clinics is seeking treatment for a condition that falls

outside of our scope of service, our clinicians expertly advocate for

patients, making sure they get the right care, in the right place, at

the right time.

Take Care Health Systems currently manages 345 Take Care Clinics at

Walgreens drugstores in 35 markets across 19 states, including locations

in: Atlanta, Boulder-Longmont, Colo., Chicago, Cincinnati, Cleveland,

Columbus, Ohio, Denver, Fort Lauderdale, Green Bay, Wis., Houston,

Indianapolis, Jacksonville, Kansas City, Knoxville, Las Vegas,

Louisville, Madison, Wis., Memphis, Miami, Milwaukee, Nashville, Tenn.,

New Orleans, Orlando, Fla., Oshkosh, Wis., Peoria, Ill.,

Philadelphia-area, Phoenix, Pittsburgh, Rockford, Ill., St. Louis,

Tampa, Fla., Topeka, Kan., Tucson, Ariz., West Palm Beach, Fla. and

Wichita, Kan.

About Take Care Health Systems

Take Care Health Systems (,

a wholly owned subsidiary of Walgreens and part of Walgreens Health and

Wellness division, is the largest and most comprehensive manager of

worksite health and wellness centers and convenient care clinics in the

country. TCHS is comprised of Take Care Consumer Solutions (

and Take Care Health Employer Solutions (

Take Care Consumer Solutions manages Take Care Clinics at select

Walgreens drugstores throughout the country. Patient care at each of the

Take Care Clinics is provided by Take Care Health Services, an

independently owned state professional corporation established in each

market. Take Care Health Employer Solutions manages primary care, health

and wellness, occupational health, pharmacy and fitness centers at large

employer campuses. Combined, Take Care Health Systems manages more than

700 worksite and retail health care centers.

About Walgreens

Walgreens (

is the nation’s largest drugstore chain with fiscal 2008 sales of $59

billion. The company operates 6,857 drugstores in 49 states, the

District of Columbia and Puerto Rico. Walgreens provides the most

convenient access to consumer goods and services and cost-effective

pharmacy, health and wellness services in America through its retail

drugstores, Walgreens Health Services division and Walgreens Health and

Wellness division. Walgreens Health Services assists pharmacy patients

and prescription drug and medical plans through Walgreens Health

Initiatives Inc. (a pharmacy benefit manager), Walgreens Mail Service

Inc., Walgreens Home Care Inc., Walgreens Specialty Pharmacy LLC and

SeniorMed LLC (a pharmacy provider to long-term care facilities).

Walgreens Health and Wellness division includes Take Care Health Systems.

Be the first to comment - What do you think?  Posted by admin - August 30, 2017 at 5:05 pm

Categories: Health   Tags: , , , , , , , , , , ,

The Fastest Growing Jobs In America

Wondering how to plot out your career path during an economic crisis, or just tired of your current job? Before you plan your next steps, consider this data about the jobs most likely to grow over the next decade. These recession-resistant professions could offer you stable employment as well as rewarding work.

Balancing what you know about your own skills and interests against what occupations are likely to be in demand will help you make an informed career choice.

In many cases, the jobs considered to be the fastest growing require specialist training. Fortunately, it is now easier than ever to train for a new career while working at another. The expansion of the Internet has made distance learning easier and more rewarding than ever. Many accredited institutions now provide top-notch training to online learners.

Service Sector Jobs Continue To Expand

It’s obvious from the news (and from the labels on your clothing) that the United States is continuing to shift away from manufacturing consumer goods. This trend is set to continue through 2016, as service-sector jobs multiply. While the financial services sector and real estate sectors have taken a hit with the latest downturn, plenty of stable, remunerative service jobs are waiting for people with the right skills and training. The four fastest-growing areas in the service sector include:

Health Care

The Bureau of Labor Statistics estimates that the health care sector alone will add nearly 4.5 million jobs to the economy by 2016. The greying of the baby boom generation will drive a need for medical personnel, both at the highest level-doctors, surgeons, and related highly-skilled practitioners-as well as administrators, care givers, and technicians. Jobs that support the work of doctors and nurses are relatively easy to train for. In some cases, a two-year associate degree can help open the door to one of these medical careers:

” Personal and home care aides

” Medical assistants

” Nursing home aides

” Veterinary technicians and assistants

” Physical therapy assistants

” Pharmacy technicians

” Surgical technologists

In addition to medical health care, mental health and social-service related careers are also set to experience increasing demand over the next several years. In many cases, workers can train for a career as a mental health professional or social service worker as a part-time or online student.


Expect about 1.4 million jobs in education to arrive in the next five to ten years. Just as a medical career doesn’t mean you need to be a doctor, an education career doesn’t require you to become a K-12 teacher. Other jobs that make up the education sector include:

” Teacher’s aides

” Pre-school workers

” Special needs teachers

” Administrative support personnel

” Library personnel

It can be relatively easy to move into education while you are mid-career in an unrelated field. In some cases, workers who already have a bachelor’s degree in one subject can qualify as teachers by taking their state’s teacher qualification exam. Other states will require more course work. Several online degree and credentialing programs exist that can help you make the move into an education-oriented career.

Information Technology

In spite of gloomy news about outsourcing, there are many jobs in the tech sector that must stay in the United States. These jobs, which frequently require a bachelor’s degree, will multiply in the near future. Job titles include:

” Network systems analyst

” Data communication analysts

” Computer application engineers

” Computer systems software engineers

” Network administrators

” Systems administrators

In addition to these back-office technology positions, there is an increasing demand for digital media professionals, such as animators and graphic designers. All of these professions can be trained for online.

Fashion and Beauty

Personal care is one of the mainstays of the service economy, and this sector will experience steady growth through 2016. While some positions, such as manicurists and pedicurists, are not especially remunerative, professional make-up artists who work with performers, skin care specialists, and fashion designers can command a good salary. Marketing professionals whose training focuses on fashion and retail can also benefit from the growth in this industry. Students looking to break into these jobs will benefit most from a blended learning approach that combines distance learning with on-campus experience.

Be the first to comment - What do you think?  Posted by admin - August 21, 2017 at 8:18 am

Categories: Health   Tags: , , , , , , , ,

Is a HSA Right For You?

If you have been looking for health care coverage and have not yet been able to find good quality coverage, you may have heard the term Health Savings Account (HSA). A HSA is a new advantage being offered to Americans to offset the costs of health care. The health savings account has become a way where you can save your money and use it for health care, and still get lower premiums on your health care coverage. How this works is that you put money aside into your tax sheltered HSA, and then you purchase lower cost health coverage with high deductibles. If an emergency arises, or you need health care, you then use the funds from your HAS to cover the cost of your deductibles and your insurance company will pay the rest. For Americans that can afford to put a little bit away, this has become a very cost effective way to get the most affordable and comprehensive health care coverage.

Be the first to comment - What do you think?  Posted by admin - August 20, 2017 at 4:22 am

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Methods of Administration for Home Health Care Main Line

There are many methods through which medication for Home Health Care Main Line can be administered. When you work in Home HealthCare Montgomery County, you must be aware of which routes are acceptable to use as a care worker. You will likely not be required to give injections. This information will be covered in your local and organizational policies.

Be the first to comment - What do you think?  Posted by admin - August 19, 2017 at 3:03 pm

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Revel United Changes the Way We Think about Health Care With New Brand Campaign for Baylor Scott & White Health | Business Wire

DALLAS–(BUSINESS WIRE)–Dallas-based integrated advertising agency, Revel

United, is turning heads and hearts with their new campaign for the

North Texas division of the recently merged, Baylor Scott & White Health

(BSWH) in Texas. With a play on words and honest messaging, Revel United

is helping to shine a light on ‘servanthood,’ a virtue that is paramount

at BSWH.

While television ads have begun to take on a ‘more of the same’ kind of

existence within the healthcare arena, Revel United sees the BSWH merger

as the prime opportunity to approach branding in a unique and

intriguing, yet authentic way –

The BSWH campaign also introduces their new tag line: “Changing Health

Care. For Life.” While double entendre is clever, it also happens to be

the perfect reflection of the focus, inspiration, and purpose behind the

Baylor Scott & White Health marriage.

This brand campaign, the first in more than ten years for Baylor, will

feature three original television ads that are currently airing on all

major network affiliates and cable news channels in the Dallas-Fort

Worth area. Digital advertising and social media will also play an

integral role in the success of this innovative campaign.

“This has been a fantastic opportunity to work with Baylor in this, the 8th

year of our working relationship together. It’s not often you get to

have the creative freedom to develop such powerful insights and work

with truly inspiring results,” says Horacio Cobos, Creative Director and

Founder of Revel United.

About Revel United

Revel United is an integrated brand communications agency headquartered

in Dallas, Texas. Revel United uses its international background to

deliver some of the most powerful human insights and truths to produce

outstanding and effective creative work. Simplicity is at the heart of

Revel United. It’s how people clearly understand what brands promise to

their customers. They take pride in asking the difficult questions—the

questions sometimes not explored, and with the answers, Revel United

develops work that moves people into action and ultimately creates

extremely successful businesses that people love. For more information,

please visit

About Baylor Scott & White Health

Baylor Scott & White Health, the organization formed from the 2013

merger between Baylor Health Care System and Scott & White Healthcare,

is today the largest not-for-profit health care system in the state of

Texas. With total assets of $8.3 billion* and serving a geographic area

larger than the state of Maine, Baylor Scott & White Health has the

vision and resources to offer its patients continued quality care while

creating a model system for a dramatically changing health care

environment. The organization now includes 46 hospitals, more than 500

patient care sites, more than 6,000 affiliated physicians, 36,000

employees and the Scott & White Health Plan.For More

Information visit:

*based on unaudited fiscal year 2014 financial statements

Be the first to comment - What do you think?  Posted by admin - at 1:48 pm

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Does your organization have DRIVE?

In this article …

Examine a process and framework for organizations to overcome

pitfalls and achieve effective decision making.

With each year, the challenges of delivering health care nationally

are becoming more and more complex. There is a real sense that a looming

crisis exists in health human resources, health financing and patient

safety. These factors are raising questions of the overall

sustainability of our system. While these questions are no different

from those asked 10 years ago, the realities of their impact are much

clearer and more immediate today.

Addressing these health care challenges requires effective

decisions that lead to successful actions and outcomes. But too often,

health care organizations are hamstrung by ineffective decision-making

processes that are neither clear nor well understood. The result is

either a lack of a timely decision or a wrong decision. We believe that

the solution is not in the decision itself but rather in the adoption of

a solid decision-making model that can be understood by a broader group

of stakeholders.

Simple model/complex process

We all have our own internal processes to determine what action we

want to take and when. These processes are known to us (even if only at

a subconscious level) but may not be known to anyone else.

In many instances we do not translate our individual processes to

the broader group or organizational level effectively. From our

experience, decision-making processes by individuals and groups need to

be formalized and articulated clearly within organizations.

Having consulted to more than 100 health care organization in

Canada and internationally, we have found that operating models and

decision-making frameworks are often ad hoc and informal. This leads to

confusion, conflict, frustration and ultimately unsatisfactory

decisions. Our belief is that the present climate more than ever before

calls for bold decisions. These decisions to be successfully implemented

rely on effective decision making.

Make it clear

In an article titled “Who has the ‘D’,” Rogers

and Blenko stress that good decision making depends on assigning clear

and specific roles and clearly identifying who is accountable for both

making, and then implementing, the decision. (1)

Building on the concepts described by Rogers and Blenko, we

developed a model that we call DRIVE. DRIVE is a mnemonic that

represents five key roles and tasks that are integral in decision


1. Decide (making the decision)

2. Recommend (recommending options for a decision)

3. Input (being part of a consultation process)

4. Veto (challenging or obstructing the decision)

5. Execute (ultimately acting on implementing the decision)

This model is a simple way to ensure that key issues are addressed

at the right time.

The DRIVE framework can be converted to a simple, concise checklist

that can be used to support any decision and any decision-making

process. For small, locally based decisions, the leader can review this

list and ensure that they have considered and assigned all roles.

For larger decisions, such as those that are initiated at the

senior leadership table, the senior team needs to discuss the various

roles, and confirm and communicate responsibilities. In either

situation, it is critical to clearly assign each of the DRIVE

responsibilities in advance of the process being initiated.

Decision breakdowns

If it is as simple as we state, why are decision-making processes

often viewed cynically and judged to be ineffective? Our explanation is

that quite often we believe that we are all on the same page when this

is not the case. As a result, attempts at realistic solutions are

hampered by:

* A lack of clarity regarding decision making roles and


* An underlying absence of formal accountability frameworks for

support decisions

* A lack of understanding of the consequences of not following

through with a decision

Without clear and appropriate decision-making processes, the

ability to solve even the smallest issue can become overwhelming for an

organization, leading to a general lack of accountability and a failure

to accomplish goals.

Using the DRIVE model, it has been our experience that hospital

leaders, either formal groups or individuals, are often very good at

defining the recommend role, but they do not always provide the

necessary clarity on any of the other roles.

As a result, many individuals believe they have the right to

provide input, to suggest or institute recommendations, to veto or make

the decision, and to influence the execution of the decision.

It is therefore not surprising that processes breakdown as those

responsible for recommending either don’t engage, or more likely,

over-engage stakeholders in the process. The result is either a

recommendation that comes forward without adequate input and support, or

recommendations that lack clarity and “teeth” and need to be

revised repeatedly before acceptance.

We have seen numerous examples of unclear and toothless

recommendations that stem directly from not clarifying and effectively

communicating the DRIVE roles, and their impact prior to decision


Also, in the absence of clarity, some individuals may feel that

they have veto power and therefore must agree in order for a decision to

be endorsed and implemented. The same is true for situations where many

feel that they should have input into every decision. Clearly failure to

clarify roles has the potential to lead to unsatisfactory processes and


Who’s the decision maker?

Finally, it is often difficult to know who is the decision maker.

Sometimes individuals may assume they have the “D”, when they

do not. In these situations, decisions can get made (or partially made)

by people who have not engaged the right parties, do not have the

appropriate authority or do not fully understand the issues on which

they have made decisions.

In other cases, no one wants to be the “D”, preferring

instead to delegate decisions upward until they reach the senior

leadership table. This upward delegation can lead to unnecessary delays,

or worse, can sabotage the process so that a decision never gets made.

If decisions are made at too high a level, these decisions may be

suboptimal, because the content experts do not sit on senior management.

Clarifying roles in advance, while essential, may also lead to

conflict. This can be problematic as most of our organizational cultures

do not deal well with open conflict in this area.

However, lack of clarity is even more deleterious to organizations.

It provides fertile ground for the nay-sayers and cynics in the

organization to disrupt the process, sabotage the desired outcomes and

may allow the wrong individuals to influence the ultimate decisions.

Clarity upfront regarding the roles in a specific decision can help to

manage this behavior.

Overcoming pitfalls

Changing cultures, creating appropriate accountability frameworks

and getting individuals used to a new way of operating is never easy.

However, in our experience the DRIVE model provides an easy-to-use tool

to assist people in acknowledging and accepting the crucial roles in the

decision-making process.

For senior teams, we encourage the CEO/COO to determine if the

roles are clear whenever the team is asking for a proposal to resolve an

issue. The team can quickly confirm:

D Who should be making this decision?

R Who should be asked to develop a proposal?

I Who has to be consulted?

V Who has a veto surrounding the recommendations?

E Who should ultimately execute? (Although this may not be known

until the recommendations come forward.)

Here’s how lack of clarity surrounding decision making can

lead to dysfunction:

Case #1: A large teaching hospital had multiple committees. Some

felt that they served an advisory function, while others felt that they

had formal decision-making authority. When probed, it became clear that

the level of authority was not well understood by all and that no actual

decision had been made by some committees in more than two years.

This was not due to a lack of interest, but rather because they

were not asked to participate in decision-making processes. Virtually

all decisions were made at the senior leadership table. Interestingly,

senior leaders expressed frustration because they felt that decisions

were actually being made by the CEO and a subset of senior leadership

outside of the formal meeting.

When decisions were brought to the senior table, there seemed to be

confusion about whether it should be decided upon by the senior group.

People also expressed that there was no clarity if a decision had

been reached, and if so what was the decision and who is now charged

with the responsibility to implement.

In this case, the DRIVE model could have helped to clarify which

decisions had to be made at the senior leadership table, versus those

that should have been made by individuals or other groups. It would have

also helped to define the “E” in these processes to reduce

confusion for whether a decision had been reached as well as who was

charged to execute or implement the decision.

Case #2: During the annual budget process at a large health

authority, individual vice presidents were asked to find a percentage

cost reduction to balance the budget. The vice president of clinical

support services identified cuts in pharmacy and presented these as his

contribution to the corporate plan.

Part of the savings plan required nursing to pick up tasks

previously performed by the pharmacy staff. Nursing leaders said that

the pharmacy cuts could not be made if they led to increased pressure or

costs in nursing.

The plan was rejected, but the VP did not have to develop an

alternate plan. In this case, it was not clear who had to agree with the

plan before it could proceed. It was even less clear whether, in the

absence of agreement from nursing, the VP had to develop an alternate


In this case, there was a lack of clarity in the “I” and

“V” roles. The proposal should have required input prior to

coming forward and, in this case, nursing might have had a veto. Had

this been done, the VP would have had to table an alternate


Case #3: The corporate human resources department in a large

multi-site health care organization was faced with budget shortfalls and

unilaterally decided to reduce the number of FTEs available to support

recruitment of staff.

This decision followed development of a Web-based job posting and

application process that HR believed would reduce the need for staff to

support the process. The cuts were made. Afterwards, it was noted that

much of the recruitment function had now shifted to the front-line

manager (e.g. scheduling of interviews, reference checking and writing

letters of offer of employment).

The end result was decreased success in recruiting staff largely

due to delays, increased frustration and an increased sense of

disconnect and conflict between corporate services and front-line


In this case, the decision-making process contributed to the

problem because a decision was made and implemented with limited input

from the individuals that it would most affect.

In the end, safe and effective care of our patients requires timely

and appropriate decisions. The DRIVE model ensures that decision-making

roles and responsibilities are clearly understood in advance of making a


As a result, the decision moves through a straightforward process,

with appropriate input, review, acceptance that can lead to a successful

implementation. The solution is a relatively simple approach that can be

successfully used on decisions of any magnitude.


(1.) Rogers P and Blenko M. Who Has the D?: How Clear Decision

Roles Enhance Organizational Performance, Harvard Business Review,

Special Edition, January 2006.


The formal decision maker. He or she is ultimately accountable for

the decision–good or bad–and must have the authority to resolve

impasses in the decision-making process as well as during


The recommenders. Typically may consult with others, but they have

responsibility to develop the ultimate proposal and recommendations.

Someone is typically assigned responsibility to formulate an initial

proposal or response to a problem or issue that is being examined.

Those with input typically will play a key role in enabling an

implementation of a recommendation because they were part of the

consultation process These individuals need to be consulted on the

decision, and their advice is typically sought by a recommender, as well

as by the ultimate decision maker, prior to the process being finalized.

Those with veto power must agree with the recommendation prior to

it going forward for a formal decision. If these individuals do not

agree, then the proposal is revamped until agreement can be reached.

Those chosen to execute. This stage provides clarity regarding

timing, expected deliverables/outcomes and consequences for failure to

act once a decision is made.

By Niranjan Kissoon, MD, CPE, FACPE, Bradley J. Campbell, MHSA, and

Nash Syed, MBA

Niranjan Kissoon


Professor in the department of pediatrics at the University of

British Columbia.


Bradley J. Campbell


President of Corpus Sanchez International Consultancy, Inc., in



Nash Syed


Senior vice president of Corpus Sanchez International Consultancy,

Inc., in Canada.


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